Rickets in a child with prolonged acquired hypothyroidism secondary to Hashimoto's thyroiditis. (18th August 2022)

• Record Type: Journal Article
• Authors: Schulmeister, Caroline; Lee, Jason; Perwad, Farzana; Long, Roger; Srinivasan, Shylaja
• Is Part Of: Endocrinology, diabetes & metabolism case reports. (2022)
• Publication Date: 2022-08-18
• Subjects: Paediatric -- Female -- Black - African -- United States; Bone -- Thyroid -- Bone -- Paediatric endocrinology -- Thyroid; Nephrology; Unique/unexpected symptoms or presentations of a disease -- August -- 2022; Endocrinology -- Periodicals; Diabetes -- Periodicals; Diabetes Mellitus; Endocrinology; Diabetes; Endocrinology; Case Reports; Periodicals; Periodicals; 616.4
• DOI: 10.1530/EDM-22-0267
• Languages: English
• ISSNs: 2052-0573

Abstract

Abstract : Summary: Skeletal abnormalities with delayed bone age and decreased linear bone growth are commonly found in children with prolonged juvenile hypothyroidism. However, rachitic bone abnormalities have not been previously reported in children with acquired hypothyroidism. Here, we present a case of newly found rickets in an 8-year-old female with untreated acquired hypothyroidism secondary to Hashimoto's thyroiditis. Laboratory finding for abnormalities in calcium/phosphorus homeostasis and hormones that regulate skeletal health was normal. Her radiographic anomalies resolved with levothyroxine treatment alone, suggesting that hypothyroidism was the etiology of the rickets. To our knowledge, this is the first case report of rickets associated with long-standing severe acquired hypothyroidism that resolved exclusively with thyroid repletion. Learning points: Thyroid hormone plays an important role in bone mineralization. Prolonged hypothyroidism can result in rachitic bone abnormalities noted on radiographs. Hypothyroidism should be considered in the evaluation of a child with rickets.